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Sunday, September 30, 2018

In the last week, cancer has sent shock waves through some lives close to ours. One of our team leaders learned their father has a very aggressive brain tumor with a median survival just over a year. Our former Bundibugyo team leader, Travis, learned that the immunotherapy trial he has been on this year is no longer helping him; his metastatic tumors are growing. He's already beat some serious odds surviving over 5 years since his diagnosis, but this news was a sobering blow to him, his young family (he got cancer in his 30s), and all of us. A dear friend and supporter (our age) learned this week that she has ovarian cancer, and it has already spread across her abdomen. Two of our Serge founders' grandchildren, young 30-40 year olds, died of cancer within a week of each other in September. That's 2 deaths, 2 new diagnoses, and 1 treatment-no-longer-working, all in people from their 30s to 60s, all Serge-associated in some way (2 of them are on our board), all in the last week to ten days. That gets our attention. These are five people who have loved well and lived well and for whom, it would make sense to us, the balance of good would benefit from keeping them all on earth for many more decades.

It's not that we should be so surprised, suffering is all around us, every day. Perhaps the suffering that is part and parcel of our hours tends to be more palpable and fightable. Surely we can infuse the right antibiotic, fix the oxygen supply, counsel with the right words, lance the boil, perform the surgery, raise the funds, that engages evil and changes the outcome. But cancer doesn't work that way. It is a brokenness insidious and hidden and pervasive and costly.

So here are two books to recommend. The first, I read this weekend. Kate Bowler is a Duke Divinity school professor and another 35-year old upended by cancer. This is a personal account, funny and raw and reflective and brutally honest. It is not a treatise on theodicy, it is her story (which is mostly how the Bible writes about God and suffering too). She grapples with the loss of control, and learning to live in the now. She grieves the sorrows loudly and she holds onto the good. But mostly she tells us the only true thing: in the worst moment of her life, she knows God is love. There are two appendices: what not to say, and how to be helpful.

The second book is equally profound. Langberg writes from her lifetime experience as a counselor specializing in trauma, particularly sexual abuse, about the way evil wounds us and how we as a church and community can respond. This book is more of a text, with illustrative vignettes but not a narrative. Her solid affirmation of a theology of suffering rings true, and her wisdom in walking alongside the sufferers is clearly and carefully laid out. In a week where not only fatal diagnoses abounded, but the trauma of sexual abuse of power was powerfully and articulately personified by Dr. Ford as millions watched the senate confirmation hearings, Langberg's book is one I would like to return to.

Neither book purports to have all the answers, which is appropriate for people who are supposedly centered on something like a cross. Mysteriously, God does not end cancer or abuse or war or the sadness of missing our families. Not yet. Instead we are plunged into this unpredictable story which arcs towards good, but passes through a thousand dark valleys on the way. We follow Jesus, who did not crush the Romans or raise every widow's prematurely dead son, but walked straight into unimaginable suffering as the means of introducing a quiet and slow redemption. Immediate incontrovertible victory sounds good, but that's not what God usually does, which is why we are still here on this earth. Kate, and Travis, and others, will probably not have their cancers disappear, but they will experience the Mercy and show us how to walk with courage on a path of love that gives space for all 7 billion of us to find God's love. Which is a miracle. And we can walk with them as friends who pray, and care, and cheer, and weep.

Let me close with one of our songs from church today: New Wine, by Hillsong. In the crushing, there is new wine pouring out. It sounds poetic until you are the one being crushed, but it is an image of Jesus and a prayer of faith all the same.

Thursday, September 27, 2018

This Fall, we are studying the lives of Abraham, Sarah, Hagar and Lot as people called to leave behind the familiar, called as a group to stake their lives on God's promises. The idea is to find wisdom for our own lives here in Naivasha. Here where we are down to TWO (from 12) medical officer interns, where there are 49 babies in NICU, where a 1375 gram twin (3lb) didn't make the cut of the 12 smallest/sickest to squeeze 3-per-incubator in our 4 boxes held together by plastic ties and tape. Where teamwork and hope must be thoughtfully inculcated day by day.

On Monday, we looked at the story of Abram and Lot getting a little too crowded and close, and needing to divide the land. Abram, who in the last story was lying to save his skin and putting his wife in peril, has grown. He affirms his family connection with his nephew, and then gives Lot first pick, willingly scooting over. This takes wisdom, and a large amount of faith that all shall be well. That his family and flocks will find provision. That we live in a world of abundance of grace, where there is more than meets the eye. That God will come through

And God does, immediately promising him again the things he longs for: children and home, descendants to carry on his name and the space for them to establish themselves. That this family will be the means of redemption and enlargement and blessing for the entire globe.

We know how the story goes later. The 12 tribes that follow from Isaac and Jacob, as well as the 12 from Ishmael, rarely get along. For brief periods, a sense of patriotism (loyalty to a larger grouping that traces back to the father, Abraham) supersedes tribal instincts, then tribalism (promoting my immediate group against other groups) fractures the nation. The tribalism and patriotism that grip us all rarely transcends to a Godly globalism. Fear, selfishness, promoting one's kin, suspicion of the others, grabbing to control resources that are perceived to be limited, seeking power to insure one's interests win out over someone less related's interests, continue to plague the generations that follow. The original idea: chosen to be a conduit of blessing to the nations, a unique group of people meant to reach out to the world, blessed to be a blessing . . . gets lost. Even in the eras where patriotism outweighs tribalism, the descendants of Abraham try to hold onto the blessing as a means for power, not as a way to pour that blessing out into the wider world. This culminates in the showdown between Jesus and the Temple priests on the night of his arrest: the religious establishment wants to control the Temple, the power, the God-on-our-side-to-conquer-all-others sense of history, and Jesus quietly and subversively goes to his death, the curtain tears, the stone rolls, the blessings start to scatter out with no limits of ethnicity or geography.

Thousands of years post-Abraham, more than two thousand post-Jesus, here we are still stuck in our tribalistic ways. Kenya's leaders are betraying the people, if Naivasha hospital is any measure of reality. Voting occurs by ethnic "tribal" groupings, those in power grab for their group and oppress the rest. Half of America feels alienated from the other half, and in spite of the fact that the vast majority of us are a crazy mixture of immigration from other continents over several centuries, unjust capture and enslavement of humans from Africa, with perhaps a trace of original nation genetics from the people who survived an annihilating onslaught of disease and a full-scale seizure of lands, many of us feel entitled to the privileges we enjoy and are afraid our happiness will be diluted if we are too generous. Like Lot, we Kenyans and Americans and pretty much most places in between want to stake out the best for those we are related to. We are afraid we won't make it unless we control the resources. Too few have an Abrahamic vision.

God, I believe, loves the whole world. God celebrates diversity of culture and language and dress and custom and food, the uniqueness of each tribe brings glory (in the visions of the indescribable, the prophets carefully mention "every tribe and tongue", a kaleidoscope not a bland mash). But where a tribe or nation seeks only, or primarily, to promote themselves at the expense of the poor, to exploit for short-term personal enrichment the resources of the globe, we are not living by faith.

This week we've heard powerful men express the same me-first mine-first tribalism and patriotism that tripped up the children of Abraham, the same attitudes that confronted Jesus. "Blessed to be a blessing" has turned into "the right to hold onto blessing for ourselves". As a global health worker, it is unsettling to hear one of the world's leaders say "we reject globalism". Time for people of faith to re-examine God's promises and challenges to Abraham, Lot, Sarah, Hagar and thousands of men and women through the ages. Time to ask hard questions, to look for ways to celebrate our tribes and countries while generously opening our hearts and hands to the world.

Tuesday, September 25, 2018

Perhaps the most important signpost in all our fog is this: you are not alone.

As a ten-day stretch of woe unfolded, we also had four sets of visitors, two prayer group meetings, worship practice, church. In other words, the bolstering reality of community, however imperfect, that reminds us that we are never alone. That no matter how frustrating or futile the work can feel, no matter how anxious or self-serving we are disappointed to find out that we are, no matter how weary or irritable we become, we are part of a larger group of people on similar paths.

Some of these are people we serve, people we have befriended, people that pray for us, people with whom we work. None of them will ever make up for all that is wrong in this world, nor will we smooth it all over for them. But by acknowledging together the losses, and hunting together for the thankfulness and joy, we are strengthened to continue.

I found this book Accidental Saints at a supporter's home this summer, and he kindly and quickly handed it over. It's not for everyone, but Nadia Bolz-Weber writes with refreshing poetic truth about the smudgy messiness and the gleaming loveliness of the community of believers. She is just edgy and challenging enough to give us a glimpse of what the counter-cultural nature of Jesus' teaching must have felt like in the context of established religion. And here is a quote that came back to my mind today:

" . . human love is never perfect. We just aren't that kind of species. There are cracks in everything and even the most shining aspects of our lives--even love, or perhaps especially love--come with imperfection. . . we always love imperfectly. It is the nature of human love. And it is okay."

So, today a pause and a tribute to the imperfect but hopeful signpost of human relationships.

Here and above, the Mixons . . we are both coming up to the quarter-century mark in living in and loving Africa.

Three Serge teens from RVA came out to Naivasha, food and sunshine and sleeping in and games for them, a taste of our missing kids for us.

Most weeks we get in a meal or two with our neighbors the Ickes family, here from Wheaton College doing nutrition research and bringing spark, liveliness, memories, and gourmet veggies into our life.

The last few days we hosted the Trinity Presbyterian (Charlottesville) Missions Director Kevin Sawyer and his associate Grady Smith. We felt very supported by the church through these representatives.

Plus it is always a treat to show off the local wildlife.

Most weeks we participate in leading worship at our local church, a few blocks walk in our neighborhood, where we can pray for our town with people who care and understand.

No photo, but the interns who came to pray with us this week also encouraged us with their faith.

So even as we long for the day when our life does not require that our immediate family (parents, siblings, kids) be spread across 3 continents, 6 time zones, 8 cities . . .we take comfort in the community at hand, and in the imperfect but shining love we give and receive.

Saturday, September 22, 2018

Some months are harder than others, and the last couple of weeks have felt like walking through a thick fog with dim lighting (more below). But even in the cloud we see God's mercy, signposts of grace if you squint your eyes and pay attention.

This young man Mutegheki Joshua came into our life when he lost his father and landed with his mother and siblings in the care of his brother, who worked for us in Uganda. Then his mother died too, and we took him under our family wing as we paid school fees and "fostered" his life. He was a good friend of our kids and a good student and we have walked through loss and celebration with him over many years. He graduated from Christ School Bundibugyo, and then two weeks ago he graduated FIRST IN HIS CLASS from Victoria University; this past week he started a job in Fort Portal, working in a business with another long-time Ugandan friend there. This is what life should look like: enfolding the orphan, sharing life, holding on through ups and downs, growth in discipleship, sacrifice and success, opportunities for transformation for us and for him. This is our dream for Christ School--the orphans and vulnerable children boosted to bring blessing back (if that resonates, here's a way to participate). It's a long road ahead for him, but this is a great first step. We are proud of his hard work and faithfulness.

These two interns are not even on the Paeds service anymore, but I found them one afternoon in the Newborn Unit helping voluntarily. More about the health system below, but I do hold onto the signpost of gracious, humble, learning people. Sharing their skills, working extra hours. I've had some great interns lately, and it is a joy to see them become independent in their skills, to hear good questions, to get their concerned calls. This is also what it's all about: passing on the art and science and spirituality of medicine. We started a life-of-Abraham based study and prayer group this month. Out of over a hundred people in the orbit of internship, students, medical officers, workers . . only one has been coming. But that's the way the Kingdom starts. Slow, subtle, subversive? Change occurs in our hearts as well, as we choose to pray and not just complain.

This baby went home. No small feat, because she started off less than half that size, a very tiny preemie in a very harsh environment. The nurses later told me that her mom had been a bar maid, unhappily pregnant, and trying to abort, but the baby cried so she brought her in. Over the nearly two months she stayed with us, this mom was caring and faithful. Perhaps this baby will bring about some transformation in her life. We pray so. But she is a signpost of the victory of life over death.

There are more signposts, sunsets that reflect glory, good meals with friends, clean laundry in the breeze, mangoes. Young Sergers in DRC have started a discipleship group for their hospital staff, even as ebola threatens to spread their way. A NEW FAMILY to work on education in Bundibugyo was approved this week for Serge, the answer to several years of prayer! Our sports-as-discipleship Nairobi leader opened roof-top playing fields to give space for youth to get out of the inner-city dangers and harshness and encounter real love.

But frankly, this post is an exercise in the discipline of gratefulness because the last two weeks in our day to day life have been quite challenging. All of this and more has happened:

-Scott goes in to do an emergency C-section, with no light, no suction, no cautery, wearing a head lamp and doing his best. Another day he has to use a side-room, again with no overhead light, and he forgot his headlamp so he manages in the dimness.

a day the lights were working . . .

-Same day I find my sickest baby with AIDS in severe respiratory distress because the oxygen ran out.

-This week, on the day scheduled for elective C-sections (those done for important indications like multiple previous scars or maternal severe illness) the maintenance team decided to close the theatre and fix all the doors. And then they didn't finish, so they closed another day. Meanwhile cases were piling up, and lives were being lost.

-A mom who had a c-section came back with her intestines slipping out of the wound . . the trainee who did it without supervision didn't tie correct knots.

-A baby who seems to have been burned, a child abandoned nearly dead at the emergency room, and many other heart wrenching stories.

-The politics continue to spiral downward, 1/3 staffing for nursing means 2 nurses caring for 40 patients. Strikes from last year continue to have an effect because medical school graduations had to be delayed, so we are trying to run a hospital that depends on interns without enough of them. The fewer the people, the more tired those left get, so then more quit. It's a vicious self-propagating sorrow. We briefly had a medical superintendent who was pushing back on the politics, and he was quickly removed by the county. Very demoralizing.

-I routinely find near-death patients on rounds. No one is noticing, or calling attention, because they are so stretched and the habits of taking vital signs are so sporadic. There is something very unsettling about being an hour into rounds and noticing the next patient looks dead.

-Twice in the last week I had to beg, make phone calls, walk five buildings over and push, just to get xrays done that revealed life-threatening diagnoses that required emergency attention. Having to push for what should be routine gets exhausting.

-The more stretched and discouraged the staff becomes, the harder it is to get people to do their job, which resulted in two stillborn babies yesterday. It's impossible to pin people down to a call schedule, there is safety in vagueness. Which means there is always a delay in finding the right medical officer or anesthetist for a surgery.

-When we come home, we counsel colleagues with even bigger problems. Miscarriages and emergency surgeries and cancer diagnoses and new ebola cases and so much evidence of the world gone awry.

We live in the cloud, seeing only a step or two at a time. But the main insight of our retreat speaker (Greg Thompson) and a key truth God has been impressing upon us for some time is this: IN THE CLOUD, GOD IS PRESENT. In fact the cloud is a physical symbol of a spiritual reality throughout the Bible. None of the above dashed points are aspects of this life that we would choose. But what if those very aspects were the way God was tearing away the obscuring veil to envelop us in a cloud of glory, to bring us into intimate dependence?

That's a truth that is very, very difficult to hold onto in the midst of the chaos. The signposts are helpful reminders God sends to keep us from totally wandering off-course. Thanks for wading through the fog with us, and praying for the signposts to appear.

(PS to those who get our direct emails for prayer: L's medical board results won't be out for 4-6 weeks.)

Our Mission

who we are

paradox:
1. something that combines contradictory features or qualities.
Life in Africa is full of contradictions - the beauty and pain; the abundance and the poverty; the joy and the sorrow.
Our lives, too...dying that we might live; strong in our weakness; sinners yet saints.
2. a "pair of docs"